Messages and notes

The two screens where a patient asks the practice for something. Both raise a notification, and both need somebody in the practice to be watching for them.

Messages

Threaded, non-urgent conversations between the patient and the office.

Conversations run down the left, the open thread fills the right, and the patient replies at the bottom. New Message starts a thread with a subject and a body. There are no attachments, no search and no way for a patient to delete a conversation.

Staff work the other side on Front Desk → Patient Messages, which is the same layout with the patient's name on each conversation, plus an unread count, an Include closed option, and the buttons to close or reopen a thread.

Messages go to everyone with the permission, not to a person

There is no inbox owner, no assignment and no routing. Every active user holding the Patient Messages permission is notified on every message. Grant it deliberately, and make sure at least one person actually has it, or messages will sit unread.

Only staff can close a conversation. Once closed, the patient's reply box disappears and their only way back is a new thread. Replying to a closed thread from the staff side quietly reopens it. Nothing is ever deleted; the exchange is part of the chart.

A guardian's message arrives under the patient's name

The sender name on a message is taken from the chart being viewed, not from the person signed in. A parent messaging about their child appears in your inbox as the child. Nothing on screen shows who actually wrote it.

One correction to the on-screen wording: the intro tells patients they will be notified by email when the office replies. What is actually sent is an in-app notification, the bell inside the portal. Unless your tenant has been set up to forward notifications to email, no email goes out, so patients will not know to come back and look.

Work & School Notes

A patient asks for an excuse note; a provider approves it, and ChiroPad writes and signs the letter.

The request asks for the type, work or school, who it is for, the dates it should cover, and any details. The list then shows the request with a status badge, and once approved a Download button for the finished note.

Staff decide on Front Desk → Note Requests. Approving opens a dialog for the signing provider, any restrictions, and a return date, plus a note back to the patient.

On approval ChiroPad generates the letter as a PDF on the practice's letterhead, addressed to the employer or school or else "To Whom It May Concern", confirming the patient was under the provider's care and unable to work or attend for the period, with any restrictions and return date, signed off with the provider's name and NPI. That PDF lands in three places at once: the patient's Work & School Notes list, their My Records, and the chart's Scanned Documents in a PortalNotes folder.

Denying simply records the decision and the reason, which the patient sees on their list.

Nothing checks the dates against real visits

The period on the letter is whatever the patient typed. ChiroPad does not confirm the patient was seen on those dates, or seen at all. The approving provider is the only check, so make sure whoever holds Note Requests knows to look at the chart before approving.

A patient can have one pending request of each type at a time, so one work note and one school note. The restrictions and return date the provider enters are printed on the letter but are not shown anywhere on the patient's list, so a patient reading the list rather than opening the PDF will not see them.

The Download button needs the My Records permission

The button on an approved note goes through My Records. A role with Work & School Notes but not My Records shows the button and fails when the patient clicks it. Grant both together.

An approved note cannot be withdrawn from this screen. If you need to take one back, stop sharing the document from the chart's Scanned Documents.